Access to mental health care eludes too many San Franciscans

No one can deny that there is a visible mental health crisis on the streets of San Francisco.

In the Mission district, it’s not uncommon to see people wandering the streets clearly agitated or in a state of acute crisis. Sometimes they are still in their hospital gowns, having just been released from the psych ward at SF General.

I believe that our public mental health care system is broken, and abandoning mentally ill people to wander the streets without care or medication is wrong. I have been very vocal about pushing the City to develop a more comprehensive system in order to provide timely and easily accessible care to mentally ill people who are living on the streets.

As I continue to push for this, I am also acutely away that it’s not only the poor and indigent who are denied access to mental health care.

San Franciscans with steady jobs and comprehensive health insurance have been unable to get mental health counselling and access the timely, appropriate care that their insurer is legally required to provide.

It’s this second, frequently ignored mental health access issue that my colleagues on the Board of Supervisors and I responded to on April 23. We voted unanimously to call on Kaiser Permanente to comply with federal and state mental health parity laws and to fix the chronic understaffing of behavioral health services that has deprived Kaiser patients of needed care.

As a lifetime Kaiser member, I can attest to Kaiser’s horrible reputation on mental health care services.

Just this past month, one of my closest friends called Kaiser to make an appointment for her 14 year old child who had been expressing thoughts of suicide. She was told that the first availability to see someone for an initial intake was a month away.

This is simply unacceptable for anyone in crisis, much less for a child. No wonder the state has ordered outside monitoring of Kaiser’s mental health services.

If this child had a life-threatening physical condition, such as cancer, this delay would never have happened. State and federal law require healthcare providers to uphold full parity for mental health care services on par with medical care for the body. Sadly, Kaiser has fallen short.

The plight of Kaiser patients would be worse if not for the advocacy of Kaiser’s more than 3,000 psychologists, social workers and other therapists. They first blew the whistle on long waits for care at Kaiser nearly a decade ago. Last December they went on strike for a week to bring attention to the fact that many of their patients wait two months, three months, or even longer for therapy appointments.

The Board’s resolution advocates that Kaiser adopt the solutions proposed by its mental health clinicians. Simply put, Kaiser must hire more clinicians, so patients don’t have to wait more than two weeks for therapy appointments. Kaiser should also limit its practice of referring tens of thousands of patients to therapists outside of Kaiser who are frequently unavailable, and who cannot coordinate their care with Kaiser doctors.

Ensuring timely and accessible mental health care for every San Franciscan is a top priority for me, as it is for many of my constituents.

With $14.4 billion in net income since 2014, Kaiser has the resources to ensure access to appropriate mental health care for all its members.

The Board’s resolution should be a wake-up call to Kaiser. It’s time for our largest private health care company to step up their game and ensure that all their patients can get the critical mental health care they need.

Supervisor Hillary Ronen represents District 9, which includes the Mission District and Bernal Heights.